LANSING, Mich. – Michigan’s top health officials spoke Wednesday about the possibility of a mask mandate, the state’s “high” COVID-19 transmission rate, the spread of the delta variant and a third dose of the vaccine.
Dr. Sarah Lyon-Callo, from the Michigan Department of Health and Human Services, gave a presentation Wednesday (Aug. 18) as COVID numbers rise due to the delta variant.
Dr. Joneigh Khaldun, the chief medical executive of MDHHS, also participated in the question-and-answer portion of the briefing.
Here are 16 takeaways from the briefing:
High level of community transmission
Michigan is currently categorized as being under a “high” level of community transmission. This categorization is when the Centers For Disease Control and Prevention recommends mask wearing by everyone when indoors, regardless of vaccination status.
COVID cases and positivity are steadily climbing in the state. The positivity rate is currently at 7.7%, with some parts of Michigan at or near 10%.
The case rate is over 100 cases per million people statewide, which is 600% higher than on June 26.
More than half of the counties in the state are at “high” transmission level, and most others are at “substantial.”
Right now, 4% of inpatient beds are being used to treat COVID patients.
COVID trends by region
Lyon-Callo said the Grand Rapids and Traverse City regions are both in the “substantial” category of transmission, while the other six regions are in the “high” category.
All but one region in the state is at or above 97 cases per million population. Case rates in most of the state continue to grow, Lyon-Callo said.
“Positivity is also increasing in most areas of the state,” Lyon-Callo said.
The Kalamazoo Region is over 10% positivity, and the region is also experiencing one of the highest percentages of inpatient bed utilization.
Mask mandates elsewhere
Places that issued mask mandates after the delta variant surge have seen a slower rate of increase in COVID cases than places that have not required masking, Lyon-Callo said.
“While other factors could have also contributed, jurisdictions with mask mandates tended to experience slower spread of COVID-19 during the delta surge thus far,” she said.
The CDC continues to urge the use of masks, among other prevention methods, in the fight against COVID and the delta variant.
Why isn’t MDHHS mandating masks?
Considering the spread of COVID and the delta variant, why isn’t MDHHS requiring masks, as other states have done?
“I’m concerned about what is happening, what could potentially happen with our schools,” Khaldun said. “We have put out and updated our guidance in the last week, and specifically recommended that schools implement a universal mask requirement so we can protect our students, keep them in-person.”
She said MDHHS is working closely with local health departments to provide information to school districts.
“We do understand that there currently is a law that would allow us to be able to implement that mandate, but at this time, the governor and the director have not made that determination,” Khaldun said.
“Throughout this entire pandemic, it has been my job to always recommend public health interventions and policies that will be protective, and I’ve continued to do that throughout the last several weeks, as well,” Khaldun said.
“Did you specifically recommend to the governor and to the director of MDHHS that we implement a mask mandate in schools?” Khaldun was asked.
“I have recommended that if a mask mandate were in place and it were followed, it would likely decrease the spread of COVID-19 in schools,” Khaldun said.
“Has the governor given you any explanation, or can you provide us with any explanation, on why we’re not doing that then?” another reporter asked. “What is there to lose at this point by having this mask mandate?”
“I cannot speak to that,” Khaldun said. “I do know that my lane is to provide public health guidance, but I also recognize that there are many other things that have to be considered when it comes to implementing a mandate.”
“Can you give us an idea of some of those considerations so we can present them to people?” Khaldun was asked.
“I cannot at this time,” Khaldun said. “I would defer to the director.”
Lyon-Callo also provided some data for children under 12 years old because they aren’t yet eligible to receive COVID vaccinations.
The Kalamazoo Region has the highest case rate for children, followed by the Saginaw and Lansing regions, she said.
Hospitalization rates for children are highest in the Lansing Region, followed by the Grand Rapids and Detroit regions.
Case trends by age, race, ethnicity
All age groups are seeing an increase in case rates in Michigan, but rates are highest in people 20-29 years old, Lyon-Callo said.
The next-highest group is people ages 30-49 years old, followed by 10- to 19-year-olds.
“With the increase in cases, we’re seeing a shift in the rates by race and ethnicity,” Lyon-Callo said. “White individuals now have the highest case rates, as do Hispanics, compared to non-Hispanics. Rates for White individuals being higher than those for African American/Black individuals just occurred around the end of July.”
Delta variant is predominant form of COVID in state
Michigan is seeing “variants of concern” in at least 81 counties, Lyon-Callo said.
“I expect that these variants are spreading other places, as well,” she said.
As for the delta variant, there are now 58 counties where it has been identified in at least one person. Lyon-Callo said that delta is twice as transmissible as the alpha variant.
“It’s making up 99% of the samples that we had available for sequencing in the last four weeks,” Lyon-Callo said.
A graphic of states that are about a month ahead of Michigan in terms of when the delta variant began spreading shows case rates here could get much higher. Michigan has already started to see a sharper increase in recent weeks.
Future expectations for delta variant
Lyon-Callo said MDHHS expects the delta variant will cause a surge in hospitalizations and cases in Michigan, based on projections derived from the current situation.
“We expect that will increase events among children,” she added.
She said that vaccines remain effective at preventing hospitalizations, even as the delta variant spreads.
“We need to continue to get vaccinated and make use of masking and other mitigation strategies that prevented transmission in the past,” Lyon-Callo said. “These will work against delta, as well.”
What if the current wave of COVID follows the growth patterns of previous surges in Michigan?
“We estimate that, based on the pattern we’re seeing thus far, we will see hospitalizations growing through September, with a peak in late September or early October,” Lyon-Callo said.
Experts said if vaccination rates stay around their current level and social contact continues to increase, delta will cause this fall to look a lot like last spring, with more than 4,000 deaths potentially occurring between the fall and winter.
“We can blunt that curve, according to this model, if we are able to increase vaccination rates to where we were in April, or if we’re able to reduce the exposures that we have and contacts with each other,” Lyon-Callo said.
Michigan could see 12,000 or more hospitalizations between August and November, experts project.
How US compares globally
While COVID cases and deaths are currently on the rise throughout the world, the United States is one of the countries with the highest case counts, Lyon-Callo said.
“Nearly all of the US is at a high level of community transmission,” she said.
Some states are even seeing case and hospitalization rates at the highest points since the start of the pandemic.
For comparison, Michigan’s hospitalization rate is still 10 times lower than Florida’s, but the positivity and case rates are both starting to climb.
MDHHS is currently investigating 183 outbreaks across the state, which is one-third more than last week, Lyon-Callo said.
The most frequent site type is in the broad “manufacturing/construction industries,” she said.
“Social gatherings continue to produce outbreaks, some of which are very large,” Lyon-Callo said. “We’ve identified 14 new outbreaks in the last week for child care and youth programs, and we have 13 new outbreaks identified in long-term care centers.”
Long-term care outbreaks tend to occur in settings where vaccination levels in staff are lower, she said.
Health care system
“Hospitalizations and ICU utilization are increasing,” Lyon-Callo said. “Deaths have also been increasing for the past two weeks.”
Michigan’s emergency department utilization for COVID-related illness has increased to 2.1% -- the largest increase in over three months.
The largest increase in emergency department utilization is in people ages 40-49 years old, but overall, it is increasing for all age groups, according to Lyon-Callo.
“The COVID census in hospitals has increased 23% to 823 inpatient beds being used for COVID, but the rate of growth in hospitalizations has slowed from what it was last week,” Lyon-Callo said.
Daily average deaths increasing
Michigan’s daily average deaths have been increasing in the last couple of weeks, Lyon-Callo said. The seven-day average death rate is still below one death per million people for those under 70.
Death rates are highest among American Indian/Alaskan native residents, she said.
This week, almost 4,000 people received their first dose of the COVID vaccine per day in Michigan.
Vaccines are being administered most frequently at pharmacies and by local health departments and hospitals, Lyon-Callo said.
In total, 4,960,000 Michiganders have completed their vaccinations. About 82% of “older adults” have completed their vaccinations, she said.
For the week ending Monday (Aug. 16), more than 44,000 doses were administered to Michigan residents.
“This graphic shows increases in vaccine first-dose uptake after the announcement about 12- to 15-year-olds being eligible for vaccination, after the lottery announcement in June, and then recently, we saw an 18-day sustained increase in first doses, which is very encouraging to see that continued increase happening,” Lyon-Callo said.
Vaccinated residents getting COVID?
Michigan is tracking the number of COVID cases in people who were fully vaccinated at the time they became ill.
MDHHS has identified 12,121 cases that meet that criteria since Jan. 1 -- less than 1% of people who are fully vaccinated in Michigan.
“The vast majority of cases, hospitalizations and deaths occur in people who have not been fully vaccinated,” Lyon-Callo said.
Third vaccine dose
With President Joe Biden expected to announce booster shot recommendations, the experts were asked if Michigan has ample supply of vaccines.
“We are certainly watching very closely what the FDA and the CDC are saying,” Khaldun said. “We are prepared and currently have ample supply of vaccines to be able to supply a third dose if people need it -- both for the immunocompromised, but also if the general public needs a third booster dose.”
She said the CDC is targeting Sept. 20 for third dose administration, and that Michigan will be prepared when that times arrives.